Traveler's Diarrhea: Don't Let It Ruin Your Vacation

Robin considered herself a seasoned traveler. She'd been south of the border before, so when she visited a friend in Mexico City, she knew better than to drink the water. But she let her guard down at a dance club in Acapulco and had a drink with ice. She spent the next 7 hours on a bus battling traveler's diarrhea (TD). "The discomfort was excruciating," Robin adds.

Traveler's diarrhea is one the most common illnesses affecting travelers. Travelers who ingest contaminated food or drink may experience a range of symptoms, including watery diarrhea, nausea, vomiting, fever, and abdominal pain, that can last for 3-7 days.

Deciding on a Location

Visitors to developing countries, like Latin America, Africa, and the Middle East, put themselves at increased risk of TD, according to the US Centers for Disease Control and Prevention (CDC). TD goes hand in hand with poor sanitation and poor refrigeration. When you travel, use your common sense when determining where and what to eat while abroad. For example, 5-star hotels that cater to world travelers are generally safer bets than open-air markets. To avoid problems, don't eat at a street corner vendor or a festival.

Having a Prevention Plan

For travelers who do not want to limit their destinations, a healthy dose of awareness can lower their risk of TD.
Here are some tips when visiting high-risk locations:

Do not drink tap water or add ice cubes. Drink only bottled water. Bottled carbonated beverages, steaming hot tea or coffee, wine, and beer are typically okay to drink.

If necessary, boiling for 10 minutes, or using iodine or cholorine tablets will disinfect tap water.

Brush your teeth using bottled, boiled, or iodine-treated water only.

Avoid raw foods, especially salads and fruits, unless you can peel them yourself.

Avoid cooked food that has been sitting out in the open, even if it is re-heated. Food still hot from an oven is generally safer.

Avoid seafood from tropical reefs. Some fish can be toxic even after cooking.

In general, you should avoid these foods:

Foods that are not steaming hot

Unpasteurized dairy products

Cold sauces and toppings

Open buffets

Undercooked or incompletely reheated foods

Fruit juices

It is a good idea to see your doctor to get antibiotics and/or anti-diarrheal medications before you go.

Getting Treatment Right Away

What if you do get sick? At the first sign of diarrhea, start with a 2- to 3-day course of antibiotics if you got them from the doctor. Start taking anti-diarrheal medications as needed for more immediate relief.

Avoid giving anti-diarrheal medication to young children, though. Young children with diarrhea should see a doctor early on because they are at a higher risk for dehydration than adults. For mild to moderate diarrhea in children, make sure your child is staying hydrated. If diarrhea is severe (10 or more watery stools per day) or the child is urinating less frequently (a sign of dehydration), get medical care right away.

Staying hydrated is an essential part of treatment for adults, as well. You replenish fluid balance better with oral rehydration salts (ORS). They can be purchased before your trip and packed in your toiletry kit or are available in most travel locations. You will have to mix the ORS with a safe water source.

Knowing When to Get Help

Seek immediate medical care for TD in any of the following situations:

Vomiting or diarrhea does not go away after a couple of days

Symptoms do not subside after 3-7 days and/or after antibiotic treatment

Lightheadedness

Worsening pain

High fever and/or disorientation

Stools are bloody and/or contain mucus

Signs of dehydration, such as decreased saliva or urination

Rapid, irregular heartbeat; chest pain

You are pregnant or caring for a young child who develops diarrhea

In some cases, TD can persist despite antibiotic treatment. Rarely, it can trigger other gastrointestinal problems. See your doctor if symptoms worsen or do not resolve.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.